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Associate General Counsel Healthcare Law

Location:
Alexandria, VA
Posted:
June 26, 2020

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DAVID H. REITER

Associate General Counsel

UnitedHealth Group Incorporated

Alexandria, VA (p) 202-***-****

e-Mail:add4m3@r.postjobfree.com

SUMMARY OF QUALIFICATIONS

• An Associate General Counsel for a Fortune 5 Insurance and Health Benefits Services Company who can provide legal and regulatory support on health law matters such as the Patient Protection and Affordable Care Act, third party administration, medical provider contracting, provider panel network leasing, medical vendor contracts, Medicaid, Medicare, Stark, the False Claims Act and other Fraud, Waste, and Abuse issues for both managed care entities and insurance companies. PROFESSIONAL EXPERIENCE HIGHLIGHTS

UNITEDHEALTH GROUP INCORPORATED Columbia, MD June 2005-Present Associate General Counsel – UnitedHealthcare Employer and Individual Legal Department

• Provide day-to-day legal and regulatory subject matter support to Specialty Benefits’ Senior Leadership Team members, proposal development writers, provider network relations, and appeals and grievance departments for managed care legal issues involving commercial and government contracts, public sector requests for proposals, bid protests, and national provider network contracting issues.

• Principal legal advisor to proposal development department and government programs business leads for public sector Medicaid, CHIP, and Medicare ancillary health benefit plan RFP, RFI, and business strategy in 16 states.

• Primary legal contact for Specialty Benefits dental and vision government programs provider-payor contracting issues, Stark and Antikickback provider issues as well as Medicaid and Medicare provider overpayment recoveries as they pertain to the Patient Protection and Affordable Coverage Act (PPACA) and the False Claims Act, and other federal and state managed care laws.

• Provide negotiation assistance, review, develop, and draft national provider network lease agreements that not only extended Specialty Benefits ancillary networks’ national footprint, but enhanced significantly its ancillary benefits business in all 50 states.

• Responsible for ancillary provider Physician Incentive Plans/Value Based contracting initiatives that resulted in increased HEDIS scores for current CMS managed care plans.

• Legal advisor to ancillary benefit managed care national product filing teams.

• Monitor, manage and review all broker and insurance commercial and Medicare Advantage marketing material for regulatory and copyright compliance.

• Provide legal advice and counsel to dental quality assurance and peer review credentialing committees on legal matters concerning provider panel members and the Healthcare Quality Improvement Act of 1986 (HCQIA).

URAC (Utilization Review Accreditation Commission) Washington, DC October 2003-May 2005

Corporate Counsel/Privacy Officer

• Provided day to day legal advice and counsel to Board of Directors, corporate officers, and senior management on legal issues that affected corporate business and operation.

• Drafted and negotiated broad range of commercial and HIPAA Business Associate agreements. Page 2 of 2

• Oversaw state regulatory filings and responses to state insurance commissioner requests, revised corporate bylaws, and provided rulings on URAC standards interpretations.

• Spearheaded and achieved Sarbanes-Oxley and related regulatory compliance through the creation and implementation of corporate best practices policies and procedures.

• Subject Matter Expert for HIPAA Privacy and Security Act interpretation for staff and clinical reviewers.

• Strategically positioned organization for statutory recognition in several states.

• Extensive knowledge of national healthcare accreditation standards (NCQA, URAC, JACHO). U.S. FOOD AND DRUG ADMINISTRATION Rockville, MD September 2002-September 2003 CENTER FOR BIOLOGIC RESEARCH and CENTER FOR DRUG EVALUATION RESEARCH Contract Attorney Position for Division of Information Disclosure

• Provided document review and legal analysis for pending Freedom of Information Act (FOIA) litigation in U.S. District Court.

• Prepared research, statutory analysis, and final legal evaluation to determine protected privilege, and FOIA exemptions under 5 U.S.C. 552 on pharmaceutical approval applications. PROFESSIONAL PUBLICATIONS AND SPEAKING ENGAGEMENTS

• Speaker, “Issues Involving Provider Contracting,” UnitedHealth Group Corporate Legal Retreat, Miami, FL (March 2007).

• Author and Managing Editor, “The Utilization Management Guide, Third Edition” (A comprehensive publication compiling the utilization review regulations of all 50 states and how health care organizations run UR/UM programs) (January 2005).

• Coauthor, “Recent Regulatory Trends in Health Utilization Management,” Health Plan & Provider

(BNA, Inc. Dec. 15, 2004).

• Moderator, “The Value of Accreditation,” URAC 2004 Spring Regulatory Conference.

• Speaker, “Health Law and Utilization Management Trends,” 2004 5th Annual Quality Summit and Exhibit, Scottsdale, AZ.

PROFESSIONAL LICENSES AND AFFILIATIONS

Admitted to the District of Columbia and Maryland State Bars. Admitted to the Trial Bar of the United States District Court for D.C. Admitted to the Trial Bar of the United States District Court for Maryland. Member of the Maryland State Bar Association.

Member of the District of Columbia Bar Association. Inactive Pennsylvania Bar.

EDUCATION AND INTERNSHIPS

Suffolk School of Law, Boston, MA, J.D. Quarterfinalist in intraschool Moot Court competition. Washington College of Law, American University, Washington, D.C. George Washington University, Washington, D.C., B.A., Economics. PRO BONO WORK

UnitedHealth Group General Counsel Pro Bono Recognition Award 2009-2019 Distinguished Recognition by UnitedHealth Group Corporate General Counsel for active District of Columbia Superior Court community pro bono service and other initiatives.



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